{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,9]],"date-time":"2026-06-09T07:26:22Z","timestamp":1780989982672,"version":"3.54.1"},"reference-count":36,"publisher":"BMJ","issue":"3","funder":[{"DOI":"10.13039\/501100001862","name":"The Swedish Research Council","doi-asserted-by":"crossref","award":["K2013-99X-22269-01-3"],"award-info":[{"award-number":["K2013-99X-22269-01-3"]}],"id":[{"id":"10.13039\/501100001862","id-type":"DOI","asserted-by":"crossref"}]},{"name":"The Family Planning Foundation"}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Sex Reprod Health"],"accepted":{"date-parts":[[2020,12,9]]},"published-print":{"date-parts":[[2021,7]]},"abstract":"<jats:sec>\n                  <jats:title>Objective<\/jats:title>\n                  <jats:p>The study aim was to establish which demographic, clinical, reproductive and psychiatric factors are associated with self-reported hormonal contraceptive (HC)-induced adverse mood symptoms.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Study design<\/jats:title>\n                  <jats:p>We compiled baseline data from two Swedish studies: one cross-sectional study on combined oral contraceptive (COC)-induced adverse mood symptoms (n=118) and one randomised controlled trial on adverse mood symptoms on COC (n=184). Both included women eligible for COC use, aged over 18 years. All women answered a questionnaire on HC use and associated mood problems. The Mini-International Neuropsychiatric Interview (M.I.N.I.) was used to capture mood and anxiety disorders. Women who acknowledged HC-induced adverse mood symptoms, ongoing or previously (n=145), were compared with women without any such experience (n=157).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Compared with women without self-reported HC-induced adverse mood symptoms, women with these symptoms were younger at HC start (adjusted odds ratio (aOR) 0.83, 95% CI 0.72 to 0.95), had more often undergone induced abortion (OR 3.36, 95%\u2009CI 1.57 to 7.23), more often suffered from an ongoing minor depressive disorder (n=12\u2009vs n=0) and had more often experienced any previous mental health problem (aOR 1.90, 95%\u2009CI 1.01 to 3.59).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>In line with previous research, this study suggests that women with previous or ongoing mental health problems and women who are younger at HC start are more likely to experience HC-induced adverse mood symptoms. Former and current mental health should be addressed at contraceptive counselling, and ongoing mental health disorders should be adequately treated.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Implications<\/jats:title>\n                  <jats:p>This study adds valuable knowledge for identification of women susceptible to HC-induced adverse mood symptoms. It should facilitate the assessment of whether or not a woman has an increased risk of such symptoms, and thus enable clinicians to adopt a more personalised approach to contraceptive counselling.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1136\/bmjsrh-2020-200658","type":"journal-article","created":{"date-parts":[[2021,1,15]],"date-time":"2021-01-15T13:21:31Z","timestamp":1610716891000},"page":"e1.1-e8","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":16,"title":["Towards individualised contraceptive counselling: clinical and reproductive factors associated with self-reported hormonal contraceptive-induced adverse mood symptoms"],"prefix":"10.1136","volume":"47","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5013-2680","authenticated-orcid":false,"given":"Cecilia","family":"Lundin","sequence":"first","affiliation":[{"name":"Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anna","family":"Wikman","sequence":"additional","affiliation":[{"name":"Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marie","family":"Bixo","sequence":"additional","affiliation":[{"name":"Department of Clinical Sciences, Obstetrics and Gynecology, Ume\u00e5 University, Ume\u00e5, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kristina","family":"Gemzell-Danielsson","sequence":"additional","affiliation":[{"name":"Department of Women's and Children's Health, Karolinska Institutet, and Karolinska University Hospital, Stockholm, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Inger","family":"Sundstr\u00f6m Poromaa","sequence":"additional","affiliation":[{"name":"Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2021,1,15]]},"reference":[{"key":"2025090510560429000_47.3.e1.1","first-page":"1264","article-title":"The changing pattern of contraceptive use and pregnancies in four generations of young women","volume":"95","author":"Lindh","year":"2016","journal-title":"Acta Obstet Gynecol Scand"},{"key":"2025090510560429000_47.3.e1.2","article-title":"Hormonal contraception increases the risk of psychotropic drug use in adolescent girls but not in adults: a pharmacoepidemiological study on 800 000 Swedish women","volume":"13","author":"Zettermark","year":"2018","journal-title":"PLoS One"},{"key":"2025090510560429000_47.3.e1.3","first-page":"1154","article-title":"Association of hormonal contraception with depression","volume":"73","author":"Skovlund","year":"2016","journal-title":"JAMA Psychiatry"},{"key":"2025090510560429000_47.3.e1.4","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejogrb.2008.07.018"},{"key":"2025090510560429000_47.3.e1.5","first-page":"45","article-title":"Ongoing or previous mental disorders predispose to adverse mood reporting during combined oral contraceptive use","volume":"23","author":"Bengtsdotter","year":"2018","journal-title":"Eur J Contracept Reprod Health Care"},{"key":"2025090510560429000_47.3.e1.6","first-page":"27","article-title":"Contraception counseling for women with premenstrual dysphoric disorder (PMDD): current perspectives","volume":"10","author":"Rapkin","year":"2019","journal-title":"Open Access J Contracept"},{"key":"2025090510560429000_47.3.e1.7","first-page":"1","article-title":"Hormonal contraception and depression: another pill scandal?","volume":"22","author":"Bitzer","year":"2017","journal-title":"Eur J Contracept Reprod Health Care"},{"key":"2025090510560429000_47.3.e1.8","article-title":"Hormonal contraceptives and mood: review of the literature and implications for future research","volume":"21","author":"Robakis","year":"2019","journal-title":"Curr Psychiatry Rep"},{"key":"2025090510560429000_47.3.e1.9","first-page":"418","article-title":"Contraceptive counselling and care: a personalized interactive approach","volume":"22","author":"Bitzer","year":"2017","journal-title":"Eur J Contracept Reprod Health Care"},{"key":"2025090510560429000_47.3.e1.10","first-page":"50","article-title":"Prevalence of psychiatric disorders and premenstrual dysphoric symptoms in patients with experience of adverse mood during treatment with combined oral contraceptives","volume":"79","author":"Segebladh","year":"2009","journal-title":"Contraception"},{"key":"2025090510560429000_47.3.e1.11","first-page":"135","article-title":"Combined oral contraceptive use is associated with both improvement and worsening of mood in the different phases of the treatment cycle - 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